Doctors have found a drug better than aspirin for warding off heart attacks and strokes in a discovery that could influence clinical guidelines worldwide.
Patients have historically been advised to take aspirin to prevent major cardiovascular events due to its blood-thinning effects.
In a new study, however, clopidogrel - also a blood thinner - appeared to be more effective at lowering the risk of cardiac events.
The findings, presented at the European Society of Cardiology congress in Madrid, stem from research led by international scientists in the US, UK, Australia, Switzerland and Japan.
The analysis of 29,000 patients with coronary artery disease (CAD) showed that those taking clopidogrel had a 14 per cent lower risk of serious adverse cardiovascular or cerebrovascular events compared to those taking aspirin.
CAD continues to pose a significant medical burden around the world, causing a huge number of deaths and disabilities.
The condition develops when fatty deposits accumulate within the heart's arteries, which causes narrowing that can trigger angina or heart attacks.
A latest report, published in The Lancet, stated: “This comprehensive synthesis of available evidence indicates that, in patients with CAD, long-term clopidogrel monotherapy offers superior protection against major cardiovascular and cerebrovascular events compared with aspirin, without an excess risk of bleeding.
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Clopidogrel is a blood thinner
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“The superior efficacy of clopidogrel vs aspirin was consistent across multiple key subgroups, including individuals with clinical features predictive of poor clopidogrel responsiveness, supporting the generalisability of these findings ot the broad spectrum of patients with CAD.
“These results support a preference for clopidogrel over aspirin for chronic antiplatelet monotherapy for patients with stable CAD.
“The widespread availability, generic formulation and affordability of clopidogrel further support its potential for extensive adoption in clinical practice.”
Researchers examined patients who had undergone stent procedures or suffered acute coronary syndrome, assessing different subgroups to ensure the results applied broadly.
Strikingly, even those less responsive to clopidogrel due to genetic or clinical factors saw better outcomes than with aspirin.
The protection came without elevating the danger of significant bleeding episodes, addressing a primary concern among clinicians.
Scientists therefore believe clopidogrel could be a more effective long-term antiplatelet option for people with coronary artery disease (CAD).
Professor Bryan Williams, the chief scientific and medical officer at the British Heart Foundation, said: “Aspirin is a commonly prescribed drug to help prevent repeat heart attacks and strokes.
Patients have historically been advised to take aspirin to prevent major cardiovascular events
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“This research suggests that clopidogrel, an alternative to aspirin, might be more effective at preventing recurrent heart attack or stroke.
“Importantly, these benefits come without a greater risk of major bleeding. These findings are likely to impact the medications doctors prescribe to their patients to reduce their risk of future heart problems.”
The researchers indicated that further investigations into cost-effectiveness and broader population studies will be necessary before treatment standards are changed.
This revelation could revolutionise treatment protocols for more than 300 million individuals globally living with coronary artery disease, including 2.3 million patients across the UK.